Spontaneous uterine perforation of pyometra leads to acute abdominal pain and septic shock: a case report

Li, Xiaoli; Ji, Lin

doi:10.5847/wjem.j.1920-8642.2022.081

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Initially, it was thought that it was a surgical emergency requiring emergency laparotomy with or without a hysterectomy and bilateral salphingooophorectomy associated with significant morbidity and mortality. 6 Medical management with injection cefoxitin 2-gram IV q8 hourly, doxycycline 100 mg BD, and metronidazole 400 mg BD PO 14 days was successful in 77% of patients, whereas medical and surgical drainage had a 93% success rate. However, surgery has postoperative complications like wound infections, ureteral injury, bowel and bladder injury.…”

Section: Discussionmentioning

confidence: 97%

Minimally invasive management of pyoperitoneum attributed by spontaneous perforated pyosalpinx and pyometra

Manisha,

Jeypal,

Yerkade

et al. 2023

Int J Reprod Contracept Obstet Gynecol

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Pyoperitoneum, apart from bowel perforation, can occur due to gynecologic causes like ruptured pyometra or ruptured tubo-ovarian abscess. Earlier, the management of pyoperitoneum included broad-spectrum antibiotics and emergency laparotomy with or without a hysterectomy and bilateral saphingo-oophorectomy. A higher rate of surgical complications like bowel or bladder injury was noted with surgery, and future fertility was also compromised in these patients. Later on, treatment strategies improved to laparoscopic drainage of pus with antibiotics without extensive surgery. However, such cases can be managed with an even more minimally invasive approach by image-guided pigtail drainage. In this report, we describe two cases of pyoperitoneum that were managed successfully with pigtail insertion and continuous drainage of pus along with antibiotics obviating the need for anaesthesia and surgery. It seems to be a promising approach for pyoperitoneum in a hemodynamically stable patient, not showing any features of severe sepsis.

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Section: Discussionmentioning

confidence: 97%